Individual provider Active NPI

Bethany Autry Robinette, NP-C

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1043768005
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901628 Issued in MS
Practice address
10556 Highway 49
Gulfport, MS 39503-4109
Phone
(228) 539-2399
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 901628 MS Primary

Addresses

Primary practice location

10556 Highway 49
Gulfport, MS 39503-4109

Mailing address

116 Clover LN
Canton, MS 39046-8842
Phone (601) 502-6042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170329000114 MS Practitioner - Nurse Practitioner 6103101464 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 24, 2018 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 24, 2018 Accepting new patients
Orange Grove Urgent Care CurrentSince Feb 15, 2017 Accepting new patients
Gulfport 49 Imaging, LLC CurrentSince May 9, 2021 Accepting new patients

Locations

1721 Medical Park Dr
Ste 340B
Biloxi, MS 39532

10556 Highway 49
Gulfport, MS 39503
Phone (228) 539-2399

2109 Hardy St
Hattiesburg, MS 39401
Phone (601) 296-3290

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1516 23rd Ave
Meridian, MS 39301
Phone (601) 553-6491

1150 S Green St
Ste D
Tupelo, MS 38804
Phone (601) 815-3575

Interoperability endpoints

  • Direct secure messaging: brobinette8467@ummc.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1043768005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CLOVER LN",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390468842",
            "telephone_number": "601-502-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10556 HIGHWAY 49",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034109",
            "telephone_number": "228-539-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINETTE",
        "first_name": "BETHANY",
        "middle_name": "AUTRY",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.